Meta-analysis of effect of body mass index on outcomes after transcatheter aortic valve implantation

Item Type:	Article
Title:	Meta-analysis of effect of body mass index on outcomes after transcatheter aortic valve implantation
Creators Name:	Sannino, A. and Schiattarella, G.G. and Toscano, E. and Gargiulo, G. and Giugliano, G. and Galderisi, M. and Losi, M.A. and Stabile, E. and Cirillo, P. and Imbriaco, M. and Grayburn, P.A. and Trimarco, B. and Esposito, G.
Abstract:	Controversial data exist regarding the impact of body mass index (BMI) on TAVI outcomes. Thirteen TAVI studies were included and analyzed for the incidence of procedural complications, 30-day, and long-term all-cause mortality. Three comparisons were executed: (1) underweight versus normal weight, (2) overweight versus normal weight, and (3) obese versus normal weight patients. Underweight patients (BMI <20 kg/m(2)) had similar 30-day all-cause mortality compared with the normal, although they displayed a significant worse survival at long-term follow-up (hazard ratio 1.68, 95% confidence interval (CI) 1.09 to 2.59, p = 0.02). Underweight patients showed a higher incidence of major and life-threatening bleedings (2,566 patients, odds ratio 1.64, 95% CI 1.10 to 2.45, p = 0.02) and of major vascular complications (2,566 patients, odds ratio 1.86, 95% CI 1.16 to 2.98, p = 0.01), compared with normal weight patients. Overweight patients (BMI ≥25 and <30 kg/m(2)) display similar 30-day and long-term all-cause mortality, as well as similar procedural complication rate compared with normal weight patients. Obese patients (BMI >30 kg/m(2)) had similar 30-day all-cause mortality rates compared with the normal weight category, whereas they displayed a significant better survival at long-term (hazard ratio 0.79, 95% CI 0.67 to 0.93, p = 0.004). Procedural complications did not differ between obese and normal body weight patients. In conclusion, a low BMI is linked to a significantly worse prognosis after TAVI. Therefore, BMI represents an important and handily tool that might be used in the risk prediction of patients to be addressed for TAVI.
Keywords:	Aortic Valve Stenosis, Body Mass Index, Transcatheter Aortic Valve Replacement, Treatment Outcome
Source:	American Journal of Cardiology
ISSN:	0002-9149
Publisher:	Elsevier
Volume:	119
Number:	2
Page Range:	308-316
Date:	15 January 2017
Official Publication:	https://doi.org/10.1016/j.amjcard.2016.09.031
PubMed:	View item in PubMed

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